Iron Homeostasis in Patients with Nonalcoholic Fatty Liver Disease

Abstract

Introduction: Serum ferritin correlates with hepatic iron deposition in patients with Non Alcoholic Fatty Liver Disease (NAFLD). Iron removal improves insulin sensitivity thereby delaying the onset of type 2 diabetes mellitus, improves liver function and NAFLD histology. Objectives: This study was done to assess the iron status in NAFLD patients and its association with fibrosis and metabolic syndrome in NAFLD. Material and Method: The study was conducted in the Department of Medicine, GTB Hospital, Delhi from November 2017 - October 2019. It was an Analytical, comparative study. Forty patients with NAFLD were selected in the study group and forty healthy subjects with no evidence of fatty liver on ultrasound were selected in the control group. The level of iron parameters recorded in NAFLD patients and the control group were compared using independent t test and p value of <0.05 was considered statistically significant. Assessment of association of various parameters of iron status with the presence of Metabolic Syndrome and fibrosis in NAFLD patients was done using the Chi-Square test. Result: The parameters of iron status namely serum iron, serum ferritin, transferrin saturation and serum hepcidin were found to be higher in NAFLD patients when compared to controls. This study also observed that there was a statistically significant positive association of serum ferritin with the presence of MetS in NAFLD patients. The study also found that serum hepcidin and serum ferritin have a significant positive association with fibrosis in NAFLD. Discussion: Assessment of iron status in NAFLD may help in early identification of individuals at high risk of fibrosis and other complications like Mets. Application of iron removal strategies like phlebotomy in such patients might improve IR and NAFLD.